MEDICARE: MR. PERCY FORD JR. MC,LPC-MHSP,NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	CC04889	MN
2	101YP2500X	Professional Counselor	068.0136584TELE	VT
3	101YP2500X	Professional Counselor	CP6091-R	NV
4	101YP2500X	Professional Counselor	39005641A	IN
5	101YP2500X	Professional Counselor	CC8059	ME
6	101YP2500X	Professional Counselor	2643	TN
7	171M00000X	Case Manager/Care Coordinator
8	101YP2500X	Professional Counselor	C10966	OR
9	101YP2500X	Professional Counselor	TPMC5074	FL
10	101YP2500X	Professional Counselor	LMHC1006116	MA
11	101YP2500X	Professional Counselor	LPC05675	AL

General Provider Information

NPI Number	:	1316075294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PERCY FORD JR. MC,LPC-MHSP,NCC

Provider Business Mailing Address
First Line	:	4183 FRANKLIN ROAD, STE B1
Second Line	:	BOX 153
City	:	MURFREESBORO
State	:	TN
Zip	:	37128
Country	:	US
Telephone Number	:	615-692-4935
Fax Number	:	855-261-6356

Provider Business Practice Location Address
First Line	:	2472 OLD FORT PKWY
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37128-4163
Country	:	US
Telephone Number	:	615-692-4935
Fax Number	:	855-261-6356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	05/23/2026

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Directions to “ MR. PERCY FORD JR. MC,LPC-MHSP,NCC” Practice Location

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